Nausea and vomiting, or a sick feeling in your stomach may be experienced after chemotherapy. Patients will be given some medication to take before and after your chemotherapy to avoid nausea and vomiting.

    How do I manage this side effect?

• Take your anti-nausea drugs as prescribed by your doctor – even if you don't feel sick to your stomach.
• Before you have chemo, make sure you've eaten something.
• Avoid spicy foods and very hot, very cold or overly acidic foods.
• Avoid strong odors like fish or perfume.
• Eat small meals often.
• Try relaxation, meditation and deep breathing techniques to help you relax.
• If you find the anti-nausea drugs are not effective, talk to your doctor so he or she can prescribe a different one.

Mouth sores (mucositis) or dry mouth can occur for one to two weeks after your chemotherapy. Let your nurse, doctor or pharmacist know if you have painful sores or white patches in your mouth. You may be prescribed some medication to help relieve the symptoms.

    How do I manage this side effect?

• Rinse your mouth with baking soda and water.

• Chew on ice chips; some women also find that frozen yogurt, ice milk or shakes made in a blender help to soothe their mouth.

• Avoid foods that irritate your mouth like spicy foods or food that is acidic or rough.

• Do not use commercial mouthwashes.

• Use a soft toothbrush.

• Eat food that is at room temperature.

• Do not smoke or drink alcohol.

• Talk to your doctor if it becomes too painful to eat.

Hair loss (alopecia) may start two weeks after your first cycle of chemotherapy. Your hair usually starts to come back four to six weeks after chemotherapy treatment stops.

    How do I manage this side effect?

To prepare for losing your hair, you may want to:

• Buy a wig – there are many styles and options these days for women undergoing chemotherapy. Ask your health care team where to buy your wig as it’s important to get the right fit.

• Try caps, scarves or turbans to protect your head from the sun or cold.

• Cut your hair before you start losing it; some women find it easier to maintain shorter hair as they lose it.

Infections can occur as chemotherapy may affect your white blood cells; the cells that help your body fight off infection. As a result, you may be at increased risk of infections. Signs of infection are fever, chills, sore throat, rash or diarrhea, or redness, swelling or pain around a wound or sore. If you experience fever, temperature of 38 C or higher, chills or signs of infection, go immediately to an emergency room and tell them you are taking chemotherapy– you may need tests and antibiotics.

    How do I manage this side effect?

• Wash your hands with anti-bacterial soap often – especially before and after meals and after going to the washroom.

• Avoid contact with people who have colds or other contagious diseases, as well as children who have recently had vaccinations.

• Don't tear or cut the cuticles of your nails – use a nail file if you need to trim your nails.

• Avoid sharp objects like razors or knives.

• If you get cuts or scrapes, keep them clean, monitor closely for signs of infection.

• Use a soft toothbrush.

• Moisturize your skin with lotion or oil if it becomes dry or cracked.

• Use gloves if you’re gardening or cleaning up after children or animals. Litter boxes should be cleaned by someone else.

• Wear shoes to protect your feet.

• Use sanitary napkins instead of tampons and deodorant instead of antiperspirant.

• Be gentle during sexual intercourse – use lubricants if necessary to avoid tears in the vagina.

Other common side effects of chemotherapy

Fatigue is common especially on the first day after treatment. Levels of fatigue differ from woman to woman. Some women take some time off work, while others are able to go on with their normal activities. If you continue to feel exhausted after your chemotherapy, let your doctor know. It’s important to maintain a balanced diet and continue to be as physically active as you feel comfortable.

Constipation or a change in your bowel habits can occur while on chemotherapy. Drink plenty of fluids, keep active and, if necessary, take a mild stool softener. If you find your constipation is a problem, talk to your doctor or nurse.

Pain and muscle aches may result from some chemotherapy drugs. The healthcare team will give instructions about what medicines to use to relieve the pain.

Menstruation cycles can be affected by chemotherapy, causing it to be irregular or stop temporarily during your regimen, and then start again. Chemotherapy may also stop your periods permanently, but this doesn’t mean you can't get pregnant, so you should use some form of contraception (do not use birth control pills or any hormone based contraception). It’s difficult to predict how treatment will affect your periods, but doctors know that changes in menstruation are more likely to happen in women closer to menopause and in women taking six months of chemotherapy instead of three months. Talk to your doctor about how your chemotherapy regimen might affect your menstrual periods.